The tempest on stem cell treatment

The stem cell plot thickens, and the controversy on the inappropriate use and gross misuse of this innovative treatment by some practitioners has seemingly reached tilting point.

Whole-page advertisements were published in major dailies stating in strong terms the sentiments and joint position of various medical organizations and subspecialty societies, most of which are under the umbrella of the Philippine Medical Association.

Curiously and ironically, the alliance was obviously against the newly formed stem cell society, the officers of which are composed of past PMA presidents.

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The Professional Regulatory Board of Medicine also issued its position statement two weeks ago in its website.

In a keynote speech delivered during the mid-year convention of the Philippine Society of Stem Cell Medicine recently, Health Secretary Enrique T. Ona described the controversy as pitting the “supposed medical scientists, the freewheeling practitioners and the regulatory arm of government” against each other.

Challenge

At the end of his speech, Dr. Ona offered what the various groups need to do. “The challenge, I believe, among us seemingly competing forces is to sit down and craft a path of consensus, taking in consideration the most fundamental tenet why our profession exists: to save life, to alleviate pain, to do no harm.”

We have written about our concerns on stem cell therapy several times in this column (7/14/12; 8/4/12, and 5/24/13). We knew that sooner or later there will be an outrage among legitimate health advocates and concerned medical organizations about the exploitation and inappropriate administration of this innovative but yet experimental treatment.

The therapy is indeed very promising, which, unfortunately, is being exploited by some unscrupulous clinics, even beauty spas and parlors. They offer it to the public, giving everyone the impression that it’s already tried and tested, charging a hefty sum of money running into millions of pesos for a course of stem cell treatment.

Stem cell device manufacturers recruit doctors to be their distributors, giving them a semblance of training and certifying them to be stem cell specialists already.

The public has to be repeatedly informed about the real status of stem cell therapy, so that they are not easily preyed upon by these unscrupulous practitioners who promote the treatment for unproven indications like diabetes mellitus, heart failure, Parkinson’s disease, autism, rejuvenation and a long list of untested indications.

Inappropriately given

It is inappropriately administered to many patients who are very sick, and “who could be easily influenced by any offer of hope; hence, they can be vulnerable to exploitation,” as Dr. Marita Reyes, head of the Philippine Health Research Ethics Board, put it during a recent meeting organized by the Philippine College of Physicians.

On the other hand, it is also being frequently given to patients who are not sick at all, and are simply just vain, wishing to look 10 to 20 years younger with the “magic potion” which they have envisioned stem cell therapy is.

“The public needs protection,” said Dr. Reyes, and we support this stand. This is not to say, however, that we should ban the administration of stem cells totally, or regulate it too strictly, leaving no elbow room for the usage of the treatment for special serious indications or end-stage conditions wherein no proven intervention is available.

We need to have more clinical experience on this innovative treatment for such indications, but control measures have to be strictly implemented to ensure that the right stem cell source, process and monitoring of response and adverse events are complied with.

Stricter monitoring

The set of guidelines on stem cell therapy issued by the Department of Health is already in place. What we need now is a stricter monitoring of its implementation and put some teeth into the law for those who willfully violate the guidelines.

There is no question that stem cell therapy is an innovative and promising treatment, but it’s not ripe for prime-time application, yet. Perhaps, given another five years, we’ll have more answers to the many questions we still have on this form of treatment to make us more confident about its safety, first and foremost, and its efficacy for specific indications. But for now, we need to temper the overenthusiasm of some enterprising practitioners and the public on the haphazard administration of this investigational treatment.

We’d like to quote again British professor, Sir Martin Evans, one of the pioneers of embryonic stem cell and gene targeting research which earned him a Nobel Prize for medicine. He said: “The scenario of a cell-based therapy or medical intervention using cells is very sound but there’s still a long way to go before it’s (considered) a safe therapy. There’s also quite a lot of jumping the gun and early adoption going on, some of which are quite cynical.”

Beware of people who are “jumping the gun” and pointing it to you without you realizing it.